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Topic:Sesamoid Bones
Sesamoid bones in horses are small, nodular bones embedded within tendons, typically located in areas subjected to high mechanical stress. In equines, the primary sesamoid bones of interest are the proximal sesamoid bones, found at the back of the fetlock joint, and the distal sesamoid bone, commonly known as the navicular bone, located within the hoof. These bones function to protect tendons, reduce friction, and enhance the mechanical advantage of tendons during locomotion. The health and integrity of sesamoid bones are essential for normal limb function, and they are often examined in cases of lameness or injury. This page compiles peer-reviewed research studies and scholarly articles that explore the anatomy, physiological role, and pathologies associated with sesamoid bones in horses.
Clinical relevance of the microvasculature of the equine proximal sesamoid bone. The blood supply to the proximal sesamoid bone of the equine forelimb was examined in 18 cadaver limbs from adult horses, using x-ray computed tomography and a tissue-clearing (Spalteholz) technique. Results of the study indicated that the proximal sesamoid bones were supplied by multiple branches of the medial and lateral palmar digital arteries, which entered the proximal half of the bones on their non-articular, abaxial surface. After entering the bone, the vessels traverse dorsally, axially, and distally, arborizing into several smaller branches that appear to supply the entire bone. The m...
Use of autogenous cancellous bone grafting in the treatment of septic navicular bursitis and distal sesamoid osteomyelitis in horses. Six horses with septic navicular bursitis or distal sesamoid osteomyelitis were treated by means of surgical debridement and lavage, followed by packing of the wound created in the bottom of the foot with an autogenous cancellous bone graft. Two horses were euthanatized, one 18 months after surgery because of complications in the contralateral support limb, and one 68 days after surgery because of continuing severe lameness. Four horses were alive 9, 16, 21, and 42 months after surgery. One horse was used as a broodmare and did not have observable lameness. Two horses were being ridden. The re...
Stress protection afforded by a cast on plate fixation of the distal forelimb in the horse in vitro. Six forelimb specimens from three adult horses had the fetlock joint fused by application of a dorsal plate and by a screw placed in lag fashion through the metacarpus to each proximal sesamoid bone. Five specimens were instrumented on the central dorsal surface of the plate with a single rosette strain gage, and the plate of the sixth specimen was instrumented with four longitudinally oriented single-axis strain gages. The specimens were loaded axially in compression to 4,000 N in a cast (test 1), in a cast with a heel block (test 2), and uncast (test 3). The principal angle of strain in all ...
A silver-impregnation and immunocytochemical study of innervation of the distal sesamoid bone and its suspensory ligaments in the horse. The innervation of the navicular bone (os sesamoideum distale) and its suspensory ligaments (ligamenta sesamoidea collateralia) (CSL) or proximal suspensory ligament and the ligamentum sesamoideum distale impar or the distal sesamoidean impar ligament (DS-impar ligament) was examined using combined anatomical techniques of silver impregnation and immunocytochemistry. Silver impregnation studies revealed an abundance of nerve fibres present in both the CSL and DS-impar ligament with the latter having relatively more nerve fibres. These silver-impregnated nerves coursed parallel to and were asso...
Nerve supply of the proximal sesamoid bone in the horse. In chronical proximal sesamoid bone lameness it is difficult to localise the exact site of pain. A specific diagnostic analgesia is not available because of a deficiency of detailed information about the nerve supply to the proximal sesamoid bones and surrounding area. A macroscopic study of the nerve distribution to the proximal sesamoid bones of 10 foals and 5 adult horses revealed that these bones are innervated by two branches, in this study called the medial and lateral sesamoidean nerve, respectively, originating from the medial and lateral palmar nerve. Histology of the left forelimbs o...
Progression and association with lameness and racing performance of radiographic changes in the proximal sesamoid bones of young standardbred trotters. Radiographic examination of the metacarpo- and metatarsophalangeal joints was performed on 753 Standardbred trotters (6-21 months of age): 21 showed obvious changes in 26 proximal sesamoid bones on lateromedial projection. The radiographic changes were divided into 6 different types: (1) irregular abaxial margin (8 horses); (2) enlargement of the sesamoid bone (6 horses); (3) 'fracture' or separate centre of ossification of the apex (4 horses); (4) vertical, non-articular fracture of the plantar part of the sesamoid bone (1 horse); (5) a small bony fragment located in a defect in the apical pa...
Substance P immunohistochemical study of the sensory innervation of normal subchondral bone in the equine metacarpophalangeal joint. Serial sections of bone and soft tissue from the metacarpophalangeal joints of 2 mature and 2 immature horses were evaluated for substance P immunoreactive sensory nerve fibers. Formalin-fixed specimens were sectioned, either nondemineralized or demineralized with formic acid or EDTA. Rabbit antiserum to substance P (SP) was used in the streptavidin-biotin-peroxidase complex method for immunolocalization of SP antigen, and staining with 3,3'-diaminobenzidine was used for permanent identification of SP fibers. Abundant sensory nerve fibers were identified in the joint capsule, synovial membrane...
Effects of short-term cast immobilization on equine articular cartilage. Hexosamine concentration (an index of proteoglycan content), DNA content (an index of cellularity), and [35S]sulfate incorporation (an index of proteoglycan synthesis) of articular cartilage were measured in biopsy specimens from medial proximal sesamoid bone, medial condyle of the third metacarpal bone, and proximal dorsal rim of the proximal phalanx in both metacarpophalangeal joints of 6 adult horses. One limb was then placed in a fiberglass cast that extended down from the proximal portion of the metacarpus and enclosed the hoof; the other limb was not casted. After 30 days of stall confin...
Arthroscopic approach and intra-articular anatomy of the palmaroproximal or plantaroproximal aspect of distal interphalangeal joints. An arthroscopic approach to the palmaroproximal or plantaroproximal pouch of the distal interphalangeal joint was developed in six cadaver limbs and seven limbs of three clinically normal horses. The dorsal aspect of the proximal border and the proximal articular margin of the distal sesamoid (navicular) bone, the palmar aspect of the distal articular margin of the middle phalanx, the collateral sesamoidean ligaments of the distal sesamoid bone, and the joint capsule attachments were readily accessible. Distending the joints with fluid gave access to portions of the articular surface between t...
Osteomyelitis of the axial border of the proximal sesamoid bones in seven horses. Destructive lesions of the axial region of the proximal sesamoid bones were identified by radiography in eight fetlocks and seven lame adult horses. Lameness ranged from 2 to 5 (mean 4; scale 1 to 5) at the time of examination, with a duration of 10 days to two years (mean 5.6 months). Destructive lesions involved both proximal sesamoid bones when examined radiographically and were situated primarily at the level of the mid-body and apical region of the axial borders. Some lesions were cystic, whereas others eroded the axial border more diffusely. Scintigraphy revealed markedly increased activ...
Lag screw and cancellous bone graft fixation of transverse proximal sesamoid bone fractures in horses: 25 cases (1983-1989). Case records of 25 horses with transverse fractures of the proximal sesamoid bone were reviewed to evaluate the success of treatment. All fractures were repaired by use of lag screw fixation and an autogenous cancellous bone graft because the fracture fragments were considered too large for surgical removal and reconstruction of the suspensory apparatus was necessary. Radiography was performed in all cases, and the fractures were classified into 3 types: (1) proximal midbody fractures, which included all fractures in the proximal aspect of the sesamoid bone that resulted in fragments involving...
Clinical relevance of radiographic findings in proximal sesamoid bones of two-year-old standardbreds in their first year of race training. Radiographs of all 4 fetlocks of 71 Standardbred racehorses were obtained at 3-month intervals for 1 year. Radiographic findings in the abaxial surface of the proximal sesamoid bones were classified into 3 types according to the severity of lesions, and correlation was made with clinical findings at time of examination. Type-1 lesions (1 or 2 linear defects less than or equal to 1 mm wide) were detected in 55% of horses at the start of training; clinical signs of disease were not manifested, and lesions did not become clinically relevant. Type-2 lesions (3 or more linear defects less than or e...
Circumferential wiring of mid-body and large basilar fractures of the proximal sesamoid bone in 15 horses. Circumferential wiring was used to repair 12 mid-body fractures and four large basilar fractures of proximal sesamoid bones in 15 horses. Eighteen-gauge stainless steel wire was placed around both fragments in five horses, and through the proximal fragment and around the distal fragment in 10 horses. The horses were returned to work when they were clinically sound and fracture healing was evident radiographically. Eleven horses resumed athletic performance, three horses were used as breeding animals, and one horse was retired. Five horses performed at an athletic level equal to or better than ...
[Chronic disease of the two sesamoid bones of the lower foot of the horse]. The aetiology and pathogenesis of navicular bone disease and sesamoidosis are discussed on the basis of findings reported in the literature and research. A marked similarity is found to be present between the clinical presentation, aetiology and pathogenesis of these two diseases. In addition, the intra and juxta-articular signs of degeneration as seen in these diseases are similar to those seen in various forms of arthrosis. Circulatory disturbances resulting from partial or complete arterial occlusion, caused by arteriosclerosis, are likely to play an important role in the cause of degenerat...
On the collateral sesamoidean (suspensory navicular) ligament of equines: topographic relations and sensitive innervation. The origin and course of the collateral sesamoidean (suspensory navicular) ligament of the horse and ass and its attachment to the distal sesamoid bone were studied by means of dissection. Particular attention was given to the topographic relations between this ligament and the deep digital flexor tendon. Numerous sensitive nerve endings are present in this anatomical district. The free and encapsulated nerve endings, displayed by impregnating techniques, are mostly concentrated in the ligament tract connected to the above-named tendon and close to its attachment to the distal sesamoid angle. ...
Arthroscopic removal of apical and abaxial sesamoid fracture fragments in five horses. Five horses with apical and abaxial fractures of the proximal sesamoid bones were treated arthroscopically. Ipsilateral and contralateral triangulation were used to remove abaxial fragments; apical fragments were removed by ipsilateral triangulation. Excellent visibility of the fracture fragments was obtained with each method. Dissection and removal of fragments was accomplished with standard arthroscopic instruments, tendon-splitting knives, and curved scissors. Excellent functional and cosmetic results were achieved in all cases.
Miscellaneous conditions of the equine foot. The etiology, clinical presentation, radiographic findings, diagnostic criteria, differential diagnoses, treatment, and prognosis are reviewed for several clinically important conditions of the equine foot. These include pedal osteitis, sheared heels, distal sesamoid bone (navicular) fractures, subchondral bone cyst of the distal phalanx, distal interphalangeal joint subluxation, congenital phalangeal hypoplasia, bipartite and tripartite distal sesamoid bones, keratoma, ossification of the cartilages of the distal phalanx (sidebones), necrosis of the cartilages of the distal phalanx (quittor),...
Pathophysiology of navicular syndrome. Navicular syndrome is a degenerative disorder of the distal half of the flexor surface of the proximal sesamoid bone that is predisposed by faulty foot conformation. In horses that become symptomatic, the faulty conformation results in sustained application of nonphysiologic pressure by the deep digital flexor tendon against the flexor cortex of the bone. This force stimulates an intense bone remodeling response in order to attenuate the pressure. An unfortunate sequela of this response is active hyperemia and edema formation in the medullary cavity of the bone. The edema is organized by fibro...
Kinematic analysis of the instant centers of rotation of the equine metacarpophalangeal joint. A kinematic analysis of the instant centers of rotation analysis was performed on 21 metacarpophalangeal joints from 11 horses. Manual and computerized methods were used to locate the instant center of rotation on photocopies of transparent composite tracings of a series of radiographs of each joint. The instant centers of rotation of the proximal phalanx about the distal portion of the third metacarpal bone were located consistently on or near the eminence for attachment of the collateral ligaments. The instant centers of rotation of the sesamoids about the distal portion of the third metacar...
Condylar fracture of the cannon bone with axial sesamoid fracture in three horses. The case histories of three young thoroughbred racehorses with displaced lateral condylar fractures combined with an axial fracture of the lateral sesamoid bone are described. In two cases the condylar fracture was repaired surgically but both horses developed severe degenerative joint disease and remained lame. The third horse was destroyed humanely. It is important that axial fractures of the sesamoid bone are recognised so that a poorer prognosis can be given for treatment of condylar fractures in racing thoroughbreds.
In vitro strength of the suspensory apparatus in training and resting horses. Forty-eight limbs of 12 freshly euthanized horses were used to generate data on the strength of the equine suspensory apparatus. The point of failure of the suspensory apparatus of each limb was determined. Immediately before euthanasia, 6 of the 12 horses (thoroughbreds and standardbreds) had been engaged in active training or racing, and six horses in stall and/or pasture activity. In the actively training or racing horses, the point of acute failure of the suspensory apparatus was within the proximal sesamoid bones in 20 (83%) limbs (resulting in 17 apical fractures, 2 basilar fractures, an...
Axial sesamoid injuries associated with lateral condylar fractures in horses. Axial sesamoid injuries were found in 4 of 18 horses with lateral condylar fractures of the metacarpus or metatarsus. The injuries appeared as axial sesamoid fractures or progressive demineralization of the axial border of one of the sesamoids. None of the horses with axial sesamoid injuries returned to performance soundness. Axial sesamoid injury appeared to be an indication of severe fetlock trauma due to condylar fracture. Such injuries appeared to indicate a poor prognosis for return to performance soundness.
Management of proximal sesamoid bone fractures in the horse. The case records of 49 horses with proximal sesamoid bone fracture were studied. The population consisted of 20 Thoroughbreds, 20 Standardbreds, 5 Quarter Horses, 2 Arabians, and 2 grade horses. The fractured bones were classified into 5 categories: apical fractures, basilar fractures, abaxial fractures, middle one-third fractures, and bilateral comminuted-distracted fractures. Apical fractures occurred most frequently in the Standardbred, with the prevalence of medial fracture being equal to that of lateral fracture. Basilar fractures occurred predominantly in the Thoroughbred, with the highe...
Sensory nerve conduction velocities in forelimb of ponies. Normal nerve conduction velocity values in 10 ponies were determined for sensory nerve fibers in the median and ulnar nerves. A percutaneous signal-averaging technique was developed and used. Medial and lateral palmar digital nerves on the abaxial surface of the proximal sesamoid bones were used as the sites for percutaneous stimulation, whereas recording sites included the medial and lateral palmar nerves just distal to the carpus and the median and ulnar nerves in the middle of the radius. Sensory nerve conduction velocities can be evaluated simply and clinically in the limbs of horses, usin...
Apical fractures of the proximal sesamoid bones in 109 Standardbred horses. One-hundred and nine apical fractures of the proximal sesamoid bones were diagnosed in Standardbred racehorses at the Ohio State University Veterinary Hospital during a 5-year period ending December 1978. Lateral sesamoids of the hindlimbs accounted for 61 of the 109 fractures, which was a significantly (P less than 0.05) greater proportion than that for fractures in all other sesamoid bones. Two- and three-year-old horses accounted for 73 of the 109 apical sesamoid fractures. The remaining 36 apical sesamoid fractures were in horses 4 to 9 years old. The apical fragment was removed in 80 of t...
